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Simulator-based training method in gastrointestinal endoscopy training and currently available simulators
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Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung
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Clin Endosc 2023;56(1):1-13. Published online January 6, 2023
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DOI: https://doi.org/10.5946/ce.2022.191
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 Abstract
 PDF PubReader ePub
- The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM’s advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator’s validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.
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Citations
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Risk Factors for Pancreatitis and Cholecystitis after Endoscopic Biliary Stenting in Patients with Malignant Extrahepatic Bile Duct Obstruction
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Ga Hee Kim, Si Kyong Ryoo, Jae Keun Park, Joo Kyung Park, Kwang Hyuck Lee, Kyu Taek Lee, Jong Kyun Lee
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Clin Endosc 2019;52(6):598-605. Published online May 28, 2019
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DOI: https://doi.org/10.5946/ce.2018.177
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Abstract
PDFPubReaderePub
- Background
/Aims: For the treatment of malignant biliary obstruction, endoscopic retrograde biliary drainage (ERBD) has been widely accepted as a standard procedure. However, post-ERBD complications can affect the lives of patients. The purpose of this study was to identify the predictive factors for these complications, including the patient’s status, cancer status, and stent type.
Methods
This was a retrospective analysis conducted in a single tertiary hospital from January 2007 to July 2017. The following variables were evaluated: sex, age, body mass index, cancer type, history of pancreatitis, gallbladder stone, previous biliary stenting, precut papillotomy, stent type, contrast injection into the pancreatic duct or gallbladder, cystic duct invasion by the tumor, and occlusion of the cystic duct orifice by a metal stent.
Results
Multivariate analysis showed that contrast injection into the pancreatic duct was a risk factor for pancreatitis. Patients with a history of bile drainage showed a lower risk of pancreatitis. For cholecystitis, the analysis revealed contrast injection into the gallbladder and cystic duct invasion by the tumor as important predictive factors. Metal stents showed a greater risk of post-procedure pancreatitis than plastic stents, but did not affect the incidence of cholecystitis.
Conclusions
Considering that contrast injection is the most important factor for both complications, a careful approach by the physician is essential in preventing the occurrence of any complications. Further, choosing the type of stent is an important factor for patients at a risk of post-procedure pancreatitis.
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Citations
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Masahiro Umemura, Eri Shimura, Yusuke Asai, Atsushi Tsuji, Masafumi Nishino, Yurimi Takahashi, Yuzo Sasada, Yasuhiko Saida, Kazuhito Kawata, Ken Sugimoto, Takanori Yamada
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A Large-Sized Phytobezoar Located on the Rare Site of the Gastrointestinal Tract
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Jee Eun Yang, Ji Yong Ahn, Gi Ae Kim, Ga Hee Kim, Da Lim Yoon, Sung Jin Jeon, Hwoon-Yong Jung, Jin-Ho Kim
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Clin Endosc 2013;46(4):399-402. Published online July 31, 2013
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DOI: https://doi.org/10.5946/ce.2013.46.4.399
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Abstract
PDFPubReaderePub
Bezoars are concretions of undigested material and are most often observed in the stomach. They can occur at any site in the gastrointestinal tract; however, duodenal localization is very rare. We report the case of a 71-year-old male who had undergone subtotal gastrectomy with gastroduodenostomy and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. An approximately 7×8 cm-sized mass was found on an abdominal computed tomography scan. On following endoscopy, a large bezoar was revealed in the duodenum and was removed using an endoscopic removal technique, assisted by a large amount of Coca-Cola infusion. -
Citations
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